Healing hands: A Sudanese doctor's account
“I am constantly haunted by the question of how to fulfill this duty in the absence of sufficient resources and personnel.”
February 27, 2024
For months, movement restrictions and shortages of lifesaving medical supplies have made medical care inaccessible to many people in Sudan, while needs soar amid ongoing conflict. Doctors Without Borders/Médecins Sans Frontières (MSF) teams are treating people injured in the fighting—along with providing maternal, pediatric, and other health care—in hospitals throughout the country. A member of our team in Sudan, Dr. Mohammed Bashir, shares below an account of providing health care in Sudan.
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Before April 15 last year, I never imagined that I would find myself in Khartoum, the capital city of our country, working in a conflict zone.
I am a doctor from Sudan and I’ve worked with MSF for several years. But I’ve never seen anything like the suffering that people in my country now are enduring daily. This conflict is devastating. More than 8 million people have been displaced by this conflict both internally, within Sudan, or to neighboring countries [totaling 10 million when combined with those displaced from previous conflicts]. People have fled the violence only to find themselves almost destitute in informal camps.
Like so many others, the conflict has not spared me and my loved ones.
A fragile health system in collapse
Sudan has long struggled with a fragile health care system, and the ongoing conflict has brought it crashing down. I have been supporting MSF teams in two hospitals in Khartoum state and another in Um Rakuba refugee camp in the east for the past months.
When people think about medical needs in a conflict, often they think about people injured by bombs or bullets. But I’ve also seen growing numbers of medical emergencies caused by complications from untreated chronic diseases. People who might have successfully managed diabetes or asthma for years are now unable to find the medications they need to live.
The need for maternal health care is also striking, especially for pregnant women requiring Cesarean sections or emergency deliveries. That is why in Umdawanban, one of the hospitals I have covered, our team has been supporting the maternity team, assisting in over 1,500 births since last July. But across the country, many maternity services have not been regularly functional, leaving pregnant women facing life-threatening complications without access to emergency obstetric care. And where health care services are available, the quality of care remains a concern.
People who might have successfully managed diabetes or asthma for years are now unable to find the medications they need to live.
As a citizen and as a doctor, I feel deep alarm when I consider the growing health needs in my homeland. Some of these concerns predate the conflict, but all of them have worsened because of it. Sudan has a troubling history of outbreaks such as measles and meningitis. These highly contagious diseases can be prevented through vaccination, but without it they can be fatal, especially in young children. One factor that puts children particularly at risk is malnutrition, which impairs the immune system.
With the collapse of the health care system and hundreds of thousands of people now having fled the violence, often living in crowded makeshift camps, large-scale vaccination programs and nutritional support are more than crucial—they are a potential lifeline.
Our determination persists, but it’s not enough
In Sudan, most of the areas where MSF is operating remain active battle zones. This makes our work incredibly challenging and dangerous, but it also makes us more determined. The determination I mention here isn't solely focused on MSF; I extend it to the communities coming together to support each other.
For instance, in Um Rakuba camp, in the east of Sudan, MSF provides desperately needed humanitarian care to thousands of people who live in and around the refugee camp. When the conflict erupted, it was unclear if it would be possible to continue our support there, but with the determination of a core team, there has been no gap in services. Last year we delivered 40,000 medical consultations to refugees as well as to the host community, and assisted 507 women to give birth safely. Our determination is shared: At Um Rakuba, I’ve seen first-hand the important role that local volunteers and community midwives are playing.
How do I hold onto my pledge in a situation when resources and helping hands are impeded and exposed to dangers? This question echoes in my thoughts both day and night.
But sometimes determination isn’t enough. My sacred oath as a doctor is to do all that I can for people who need medical care. And in my role as an MSF deputy medical coordinator, that means not only treating individual patients, but also coordinating care on a larger scale, ensuring that staff and supplies are where they are needed most.
But how do I hold onto my pledge in a situation when resources and helping hands are impeded and exposed to dangers? This question echoes in my thoughts both day and night.
It’s now a matter of life and death that all parties to this conflict recognize MSF’s sole purpose: to offer medical care to the most vulnerable people, free of charge. We need access and to safeguard our teams and supplies as much as for patients—not tomorrow, but now. The lives we strive to save depend on it.
My work in Sudan, my country, is not just a job; it's a part of my humanity. And my ethical duty is that I, like my colleagues at MSF, do all we can to relieve suffering in the face of conflict.
And I remain dedicated to this cause.
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About Dr. Mohammad Bashir
Dr. Bashir has worked with MSF for several years. He supervises medical activities at Umdawnban and Alban Aljadeed hospitals in Khartoum state, which have been supported by MSF since the summer of 2023. At Umdawnban Hospital, our team provides pediatric and maternal health care, and Alban Aljadeed Hospital stands as the sole operational public hospital in East-Nile. MSF has supported the emergency room and operating theater, and have provided more than 12,000 emergency outpatient consultations since August 2023.
Dr. Bashir also worked with the medical team at Um Rakuba refugee camp in Al Gedaref state, where we delivered 40,000 outpatient consultations in 2023 alone.
His role extended to handling health emergencies such as our response to a cholera outbreak. His efforts in two of these hospitals provided vital support to approximately 500 people affected by the cholera outbreak in 2023.
MSF in Sudan
Currently, MSF teams work in 11 states in Sudan: Khartoum, Al Jazirah, White Nile, Blue Nile, River Nile, Al Gedaref, West Darfur, North Darfur, Central Darfur, South Darfur, and Port Sudan states. We are also providing assistance to refugees and returnees across Sudan’s borders, in South Sudan, Central African Republic, and Chad.
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